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- January 7, 2009 |
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CME on Diabetes is a website built to transmit top-level CME conferences given by international experts in endocrinology, insulin resistance, prediabetes, metabolic syndrome and type 2 diabetes. More than 2.6 million slides have been viewed since the website launch. Thank you for your continued support and commitment!
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"Does the Metabolic Syndrome Predict Death in Type 2 Diabetes? The Fremantle Diabetes Study"Prof. Timothy Davis (biography)
English - 2005-04-15 - 20 minutes
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Summary :
The Fremantle Diabetes Study (FDS) was a prospective, observational study of a representative patient cohort recruited from 1993 to 1996 and followed for at least 5 years. The FDS cohort comprised 1426 patients (63% of all diabetic individuals identified in a catchment area of 120,000 people), and 1294 (91%) had type 2 diabetes. Prospective outcome data were obtained through the Western Australia Research Linked Database. The baseline percentages of the type 2 FDS patients with the Metabolic Syndrome (MS) were 82.7% by WHO and 79.8% by ATPIII criteria. There were 369 deaths (28.5%) during follow-up. WHO-defined MS was associated with an increased risk of all-cause and coronary heart disease (CHD) mortality (P=0.0012 and 0.0037, respectively by log rank test), whereas ATPIII-defined MS was not (P>0.24). We used Cox proportional hazards modelling to assess the role of WHO-defined MS as an independent predictor of death, excluding variables which defined MS from the model. For all-cause mortality, age, gender, smoking, exercise, history of CHD or stroke, retinopathy, neuropathy and indigenous background predicted death (P<0.02 in each case), but WHO-defined MS did not (P=0.57). For CHD death, there was a similar risk factor profile except that glycosylated haemoglobin was in the model (P=0.004) while exercise was not. MS was not an independent determinant of CHD death (P=0.80). We conclude that Metabolic Syndrome is common in patients with type 2 diabetes. The WHO definition is a stronger predictor of all-cause and CHD mortality than ATPIII, but neither adds significantly to other known risk factors.
Learning objectives :
After viewing this presentation the participant will be able to discuss results from the Fremantle Diabetes Study relating to:
- Prevalence of metabolic syndrome in type 2 diabetic patients
- Metabolic syndrome as a predictor of all-cause and CHD mortality in type 2 diabetic patients
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